Individual
LAURA JEAN BALAVITCH-GOMEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
36549 HARPER AVE, SUITE B, CLINTON TWP, MI 48035-2012
(586) 791-3150
(586) 791-0409
Mailing address
36549 HARPER AVE, SUITE B, CLINTON TWP, MI 48035-2012
(586) 791-3150
(586) 791-0409
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
5601001632
MI
Other
Enumeration date
05/15/2007
Last updated
07/08/2007
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